• Nurullah Hamidi, Tuncel Uzel, Aykut Demirci, and Halil Basar.
• Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, Turkiye.
• J Coll Physicians Surg Pak. 2024 Oct 1; 34 (10): 120512101205-1210.

ObjectiveTo determine clinically significant prostate cancer (csPCa) detection rate by combining the prostate-specific antigen density (PSAD) and prostate imaging-reporting and data system (PI-RADS) scores.Study DesignDescriptive study. Place and Duration of the Study: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital, from January 2018 to April 2023.MethodologyPatients who underwent prostate biopsies after multiparametric magnetic resonance imaging (mpMRI) were included in the study. PI-RADS 4 and 5 lesions were considered as MR positive. The cut-off values for PSAD were also determined to evaluate csPCa. csPCa detection rates were evaluated by grouping the patients based on the PSAD and mpMRI findings.ResultsPSAD cut-off value of 0.165 ng/mL/mL (sensitivity 80%, specificity 72%) was detected to predict csPCa (AUC = 0.81, 95% CI:0.756-0.866, p<0.001). csPCa detection rate was low (3%) in patients who have low PI-RADS scores (1-3) and a PSAD <0.165 ng/mL/mL. On the other hand, csPCa detection rate was high (50.5%) in patients who have a high PI-RADS score (4-5 lesions) and with a PSAD ≥0.165 ng/mL/mL.ConclusioncsPCa detection rates are low in patients with PI-RADS 1-3 lesions and low PSAD values. Unnecessary biopsy may be avoided in these patients.Key WordsGleason score, PI-RADS, Prostate cancer, Prostate-specific antigen, Prostate-specific antigen density.

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